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Ministers launch fluoride drive
http://news.bbc.co.uk/2/hi/health/7227859.stm Johnson interview
National breakdown
Health Secretary Alan Johnson has called for fluoride to be added to England's water supplies as a key means of tackling tooth decay.
He wants strategic health authorities (SHAs), which are already able to compel water companies to add the chemical, to use those powers.
Critics argue the long term health risks of fluoridation are unknown.
But advocates, including much of the medical profession, say it is a safe, proven way of improving dental health.
Mr Johnson said he wanted public debate at a local level before any such measures are carried out.
"I don't want this to be carried out in areas where there has been no consultation whatsoever," he told the BBC.
"But every time the public hear the arguments they overwhelmingly go for fluoridisation - the problem is the debate has stopped."
Final say
At present, about 10% of England's water is fluoridated - mainly in the north-east and West Midlands.
Fluoride is only being added to prevent tooth decay among a relatively small proportion of the population, mostly children in deprived areas who do not brush their teeth
National Pure Water Association
Analysis: Fluoridation
While legislation was introduced in 2003 giving SHAs the final say on whether fluoride should be added to local supplies, so far none of them have made use of those powers.
The government has no power itself to compel SHAs to act.
The last time a fluoridation scheme was introduced was 1985.
Anti-fluoride campaigners say more research is needed to establish the risks. There have been suggestions of a heightened risk of cancer, infertility and bone fractures, but these have never been substantiated.
However excess fluoride is associated with discolouring of the teeth, a condition known as fluorosis.
But Mr Johnson said this only came about when children "ate toothpaste".
He added such schemes had been in operation since the 1940s in the US - where some 70% of water supplies are fluoridated - with no ill effect.
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Birmingham meanwhile first introduced fluoridation in the 1960s.
"If you look at the average five-year-old in Birmingham compared with an average five-year-old in Manchester you see not just a marginal improvement in Birmingham, you see a huge - 50% improvement - in that child's dental health."
The government has set aside £42m to help SHAs carry out the consultation and implementation process.
The National Pure Water Association argued that the rights of the majority were being overruled for the benefit of a small minority.
"Fluoridation is carried out by water companies in violation of their customers' human right to refuse consent to any medical intervention.
"Section 58 of the Water Act 2003 is therefore bad law as it conflicts with other UK and EU law."
But Dr Vivienne Nathanson, of the British Medical Association, described the fact that more funds would be set aside for local flouridation schemes as "good news".
"We believe that the fluoridation of water is an effective public health strategy for reducing tooth decay in the population."
